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CHIP EDUCATION PROJECT. Karin Dunn HCHD/Gateway to Care. Origins. Mandated by the 1999 Texas Legislature to determine efficacy in reducing costs when using peer-to-peer educators Community Health Workers Promotores de Salud Lay Health Workers About 70 other titles
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CHIP EDUCATION PROJECT Karin Dunn HCHD/Gateway to Care
Origins • Mandated by the 1999 Texas Legislature to determine efficacy in reducing costs when using peer-to-peer educators • Community Health Workers • Promotores de Salud • Lay Health Workers • About 70 other titles • Project Started in January 2006 and projected to continue to December 2008, serving 8,103 families
Project Overview • Educate Harris County CHIP families on how to appropriately use benefits • PCP as “medical home” • Ancillary Benefits (Dental & Vision) • Case Management • Identify barriers to use (language/culture, transportation, etc.) • Provide options to overcome • Insure that parents have HMO’s member service line number and nurse triage lines
Referral Mechanisms • Provided by Health Plans based on self-defined criteria • Emergency Room Usage (frequent/primary care related) • Near end of term • Navigators identified from patients of clinics where they are co-located • Since June 2007, have received a sample of newly enrolled families on CHIP directly from HHSC
Served through Febuary 29, 2008 • Educated 4,877 families • Another 1,213 were educated, but were off CHIP as time of service
Findings to Date • Parents are confused by Program due to multiple changes over past 5 years and multiple errors encountered • Parents do not understand how managed care fits into benefits package – do not understand that member service line is available for problems with providers or for other issues
Findings - continued • Parents do not understand that ancillary benefits available – dental & vision • Parents have no knowledge of plan-provided nurse triage line • Parents do not know who to notify of address change • Families with child(ren) moving from Medicaid are often moved to another health plan.
Additional Outcomes • Community Health Worker Training Institute • 5 certification classes (160-hour each) • Continuing Education classes to maintain certification • CHW Regional Symposium • Navigator Associates Training